CLB

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Notice of amendments

Contract identification data

Name of the contracting party:

Zip code of the contracting party:

City of the contracting party:

Name of street and street number of the contracting party:

Telephone number:

Email address:

CLB contract identification number:

Policy number:

License plate number of the vehicle
(format: AAA-111):

Type of the contract to be amended:

Data to be amended
(Please, fill in the data field to be modified!)

Mailing address, zip code:

Mailing address, city:

Mailing address, street, street number:

Phone number:

Fax number:

Mobile number:

E-mail:

Request for amending the fee payment data

New payment term:

monthly quarterly six monthly yearly not amended

New method of payment:

postal check transfer collection not amended

If you prefer payment via collection, under the "unload documents" menu, you shall find the forms of the insurers, which after printing and signing should be sent to our address via mail.

Notice of amendment to be proved by documents
Below you can report any mistake of data of your contract, or amendments of the data, which we have to prove to the Insurer by copy of the original document. Your notice shall be finalized by us upon receipt of the verifying documents by our Company. If you can, please upload the documents on our website. If you cannot do it, please fax them to our fax number: 473 - 3030 or send it via mail (1364 Budapest, PF. 316.)

Data to be amended	Necessary document to prove	Document upload
Name of the contracting party (e.g. name by marriage, maiden name, typo)	Personal identification card	Upload
Address of the contracting party	Registration book	Upload
Date of birth (typo)	Personal identification card	Upload
Degree of fault	Original certification of history of losses	Upload
License plate number	Registration book	Upload
Type	Registration book	Upload
Make	Registration book	Upload
Model	Registration book	Upload
Chassis number	Registration book	Upload
Engine number	Registration book	Upload
Cylinder capacity	Registration book	Upload
Extras	Invoice proving that it was built in	Upload